1. Field of the Invention
The present invention relates generally to an apparatus and method for repair of tendons and in particular to an elongated apparatus having barbs for insertion into a severed tendon to secure the ends of the severed tendon to one another.
2. Description of the Related Art
Tendons are tough cords or bands of dense white fibrous connective tissue that unite a muscle with some other part of the body (such as a bone) and transmit the force which the muscle exerts to that body part. In general, a tendon is designed to transmit force of a muscle to a bone across a joint. The main constituent of a tendon is type I collagen, although other types of collagen as well as other materials are present in small quantities. Long strands of collagen protein, known as fibrils are bundled with tenocytes into fascicles, which are held together with the endotenon, a loose connective tissue, to form fiber bundles that are collected to form the tendon. Tendons may become damaged and require repair or they may be severed such as by an injury and must be reconnected. Tenorrhaphy is the surgical suture of the divided ends of the tendon, sometimes called tendinosuture or tenosuture.
Much of the tenorrhaphy literature focuses on increasing the tensile strength of the repaired tendon in order to decrease the tendon rupture rate associated with early mobilization of the effected body part. Early mobilization is important to avoid adhesion of the healing tendon to the surrounding tissue by strands of scar tissue. Various techniques of suturing the ends of the tendon together have been proposed, these involving different configurations of suture threading through the tendon and between the severed ends. The techniques include core suturing and peripheral suturing. Multiple strands of suture material extend between the tendon ends in these proposals. Some literature suggests decreasing the number of strands bridging the repair site in order to minimize soft tissue dissection, decrease the operative time and limit handling of the injured tendon. It is still important to repair a tendon with sufficient strength to allow early mobilization, but the achievement of strength at all costs is no longer considered essential. A current preferred method of flexor tendon repair is a four strand technique using four suture strands extending between the ends of the tendon. This number of strands achieves sufficient strength to allow early passive or light active mobilization, however four strand repairs remain relatively complex.
There is a desire to provide a tendon repair that is less complex to perform, reduces handling of the tendon, reduces surface roughness of the repaired tendon, and enables early mobilization of the affected body part.